Endocrine Abstracts

Background: Knowledge of Cranial Diabetes Insipidus (CDI) is poor amongst healthcare professionals. Intra-nasal Desmopressin sprays are often mistaken for pulmonary inhalers, and Diabetes Insipidus mistaken for Diabetes Mellitus, leading to incorrect management and harm. Correct Desmopressin administration and fluid management is paramount in inpatients, especially in reduced conscious states.Aim: To explore Clinicians’ concerns regarding safety iss...

Background: Nationally, there has been a concerted drive to utilise technology to support the provision and delivery of specialist services. Within our local area, both secondary care and 95% of GP surgeries utilise the Systm-One electronic health care record. Since October 2016, we have been providing a local Endocrine E-consultation service. A GP requiring advice, rather than referring the patient to the hospital would (after obtaining patient consent), share their record, t...

Background: The internet is widely consulted for health-related information (HRI). Online health information (OHI) seeking behaviors have never been investigated in the field of endocrinology.Objective: We examined the frequency, how and why the internet is utilized for HRI, the impact of such activity and the future information needs of our patients.Methods: A cross-sectional mixed-methods study was performed with more quantitativ...

We report the results of the first Europe-wide survey of patients with multiple endocrine neoplasia (MEN) disorders by the European MEN Alliance (EMENA). METHOD: An online questionnaire was distributed via patient groups, social media and health professionals. A total of 284 responses were analysed. RESULTS: 35% (n=99) UK responses and 65% (n=185) from 17 other EU countries: 68% female, 32% male (UK; 75% and 25%). Disorders represented were: MEN1 n=2...

Introduction: Premature ovarian insufficiency (POI) affects approximately 1% of females. In POI, hormone replacement manages symptoms and reduces the risk of bone mineral density (BMD) loss as oestrogen acts to enhance bone deposition in bone remodelling. Oestrogen may be given either as synthetic oestrogen (ethinylestradiol) as in most combined oral contraceptives (COCP), or as physiological oestrogen (oestradiol) as in hormone replacement therapy (HRT preparations) and a sel...

Introduction: Transgender medicine is a rapidly expanding field and GPs have historically played a vital role in prescribing hormones therapies for those with gender incongruence. Despite this, some GPs are refusing to prescribe medication recommended by the Gender Identity Clinic (GIC) in London. This problem is persisting despite the GMC guidance that prescribing is the GPs responsibility. The aim of this audit was to establish reasons why GPs are refusing and if there were ...

We report the results of the first Europe-wide survey of the Quality of Care of patients with multiple endocrine neoplasia (MEN) disorders by the European MEN Alliance (EMENA).Method: An online questionnaire was distributed via patient groups, social media and health professionals. A total of 284 responses were analysed.Results: 35% (n=99) of responses were from UK patients and 65% (n=185) from 17 other EU countri...

Background: A Turner Syndrome (TS) Transition clinic, Royal Hospital for Children Glasgow(RHCG), with paediatric and adult endocrinology/gynaecology teams was set up in 1998.Objective: 1) To evaluate the success of TS transition2) To determine what factors influence long-term follow-up in an adult service – good early attendance in an adult clinic and meeting an adult specialist prior to transfer to adult clinic.<p class="...

Background: Electronic endocrinology advice and Guidance (e-Endo A&G) via NHS e-Referral Service was introduced at University Hospitals of Leicester NHS Trust (UHL) in March 2017 to address General Practitioners’ (GP) non-urgent endocrinology clinical concerns. Primary aims of the service, was to prevent inappropriate outpatient visits, avoid acute admissions and reducing length of time in resolution of queries.Objectives: To retrospectively eva...

We audited 46 pituitary MRI scans for patients with hypogonadotropic hypogonadism. We were particularly interested to see if adopting The Endocrine Society’s (TES) 2010 guidelines for Testosterone Therapy in Men with Androgen Deficiency Syndromes (pituitary MRIs only for those with testosterone level below 5.3 mmol/l, panhypopituitarism, persistent hyperprolactinaemia or if the patient has symptoms consistent with a mass effect such as headaches, a visual field defect or ...

Background: Transsphenoidal surgery is the primary therapy in majority of Acromegaly patients with GH-secreting somatotroph adenomas. Reported outcomes of surgery show an initial remission rate of 40–50% for macroadenomas and >85% for microadenomas. Rates of hypopituitarism following endoscopic pituitary decompression vary between 5 and 25%. Invasion of cavernous sinus indicates the tumour is unlikely to be resectable.Methods: We audited the res...

Introduction: Gynaecomastia, a benign enlargement of glandular breast tissue in males, may be associated with anxiety, depression and reduced self-esteem.Aims: To assess current practice in management and treatment outcomes in the management of gynaecomastia with a view to improving quality of service and rationalising investigations and referral pathway.Methods: A health informatics search identified 42 patients with documented gy...

Background: Approximately a third of pregnant women in the UK are Vitamin D deficient, which may confer deleterious consequences, including an increased risk of pre-eclampsia, gestational diabetes mellitus, and intrauterine growth restriction. Vitamin D supplementation in pregnancy has shown to be beneficial, including a reduced risk of pre-eclampsia and pre-term birth, compared to placebo. This audit investigated the extent to which women attending an ante-natal centre adhere...

Background: A large proportion of patients who attend the Endocrine clinic have thyroid dysfunction, usually thyrotoxicosis. These patients require regular thyroid function tests (TFTs) and advice on medication dose alteration, usually through frequent clinic appointments. At our University Teaching Hospital, we have a nurse-led system whereby TFT monitoring and advice is managed virtually, with patients usually attending clinic annually for review. We call this the Thyroid Sh...

Patients with Familial Hypercholesterolaemia (FH) have premature Cardiovascular disease and have a standardised mortality ratio nine times greater than normal. FH must therefore be correctly diagnosed and treated aggressively. Referral for FH is based on fulfilling the Simon Broome’s (SB) Criteria. We aimed to evaluate practice at Queen Alexandra Hospital with regards to referral for FH genetic mutation. We set out to see whether SB’s criteria were being fulfilled wh...

NOTICE OF RETRACTION: This abstract is retracted at the request of the author.This study aimed to re-audit the surgical and medical treatment of acromegalic patients in the Sussex Pituitary Multidisciplinary Team (MDT). This involved assessing biochemical control and treatment complication rates. The study compared treatment outcomes with previous 2010 audits and national published standards. Fourty patients (25 males, aged betwe...

Prompt, effective and safe management of Diabetic Ketoacidosis (DKA) is key to reducing mortality rate and length of stay. An Integrated care pathway (ICP) Pro-forma for DKA management during the first 24 hrs, based on a modified JBDS guideline was introduced in the trust. DKA management based on the pro-forma between Nov 17 to Feb 18 was audited; focussing on fluid management in terms of timing and electrolyte replacement, CBG monitoring, faster senior reviews, HDU admissions...

Background: TS, resulting from partial or complete loss of an X-chromosome, is a rare diagnosis1. In addition to its well-described phenotypic features2, a number of multi-systemic conditions may develop over the lifespan of a Turner female that require long-term surveillance which is challenging to deliver in today’s ‘specialised’ services NHS.Aim: To evaluate UHL service provision against the only guidelines for the...